liver function test

Question 1

what is cholestasis

Answer 1

failure to produce or excrete bile

Question 2

what are the classifications of liver disease

Answer 2

infection
drug induced
autoimmune
billiary 
vascular
metabolic
neoplastic

Question 3

what is acute hepatic failure

Answer 3

development of dysfunction within 24 weeks of disease

Question 4

what is chronic hepatic failure

Answer 4

progressive decline in liver function with established disease

Question 5

what are the main causes of acute hepatitis

Answer 5

drug e.g. paracetamol
inadequate perfusion
infection

Question 6

what are common causes of chronic liver disease

Answer 6

alcoholic fatty liver disease
chronic active hepatisis
primary billiary cirrhosis (cholangitis)

Question 7

what are the consequences of chronic liver disease

Answer 7

cirrhosis
portal hypertension 
ascites
renal failure
oedema
bruising

Question 8

what are the consequences of portal hypertension

Answer 8

gastric/ oesophageal/ anal varices
hepatic encephalopathy
hypersplenism

Question 9

what are the features of liver failure

Answer 9

inadequate synthesis of albumin and clotting factors

inability to eliminate nitrogenous waste and bilirubin

Question 10

what is hepatic encephalopathy

Answer 10

products normally
metabolised by the liver accumulate in
the systemic circulation.

e.g. ammonia

Question 11

what liver function tests are there

Answer 11

aminotransferase
bilirubin
ALP for biliary epithelial damage/ obstruction
albumin

Question 12

how is bilirubin excreted

Answer 12

as urobilinogen or in bile

Question 13

what does AST and ALT stand for

Answer 13

aspartate aminotransferase and alanine aminotransferase

non specific markers of acute liver damage

Question 14

what is ALP

Answer 14

increased in liver disease due to increased synthesis in response to cholestasis

it is a protein

alkaline phosphatase

Question 15

what is gamma GT

Answer 15

raised in cholestasis also affected by alcohol and drugs

Question 16

what are the limiations of biochemical tests

Answer 16

lack of specificity
may be over sensitive
enzymes are not exclusively found in the liver

Question 17

what can LFTs be used for in asymptomatic patients

Answer 17

check for haemolysis
pregnancy
skeletal muscle disorders

Question 18

what is the marker for liver cancer

Answer 18

alpha fetoprotein

Question 19

what are copper studies done for

Answer 19

Wilson’s disease

Question 20

what are antibodies assessed for

Answer 20

chronic active hepatitis

Question 21

how else can the liver be investigated

Answer 21

liver biopsy

radiology

Question 22

what is Gilbert’s syndrome

Answer 22

high levels of bilirubin
liver has difficulty removing bilirubin from the blood

bilirubin levels fluctuate

usually present during illness or fasting
no treatment required

Question 23

what is pruritis

Answer 23

itching

Question 24

what is high ALP with normal ALT indicative of

Answer 24

cholestasis

Question 25

what can caused raised levels of ALP

Answer 25

pregnancy

Question 26

what does alchohol affect

Answer 26

levels of GGT

Question 27

what are the possible causes of increased ALP

Answer 27

cholestasis
pregnancy
bone growth

could be increased in chronic or acute liver failure

Question 28

what LFT would you expect to find in cholestasis

Answer 28

increased bilirubin, ALP, gamma GT, ALT

Question 29

what would you expect to find in chronic liver failure

Answer 29

normal results or slightly increased

Question 30

what would you expect to find in acute liver failure

Answer 30

increased bilirubin and ALT

Question 31

where is ALP found

Answer 31

lining the bile ducts, placenta, bones

Question 32

a patient has raised ALP and GGT

Answer 32

bile tract disease

Question 33

raised ALP normal GGT

Answer 33

bone disease or pregnancy likely